The rapid pace of technological innovation is reshaping the environment of injury prevention, rehabilitation, and performance.
Specifically, integration of machine learning and artificial intelligence have allowed for more effective analytics for data-driven decision-making. Advances in biomechanics, motion analysis, virtual reality, and wearable technologies have provided insight into how the body moves and functions during sport and recovery, providing real-time analysis of joint and muscle activation and physiologic parameters to help identify inefficiencies and risk patterns. This data may be employed to target interventions and optimize technique.
As technologies continue to be refined and products become more efficiently scaled, cutting-edge sports science technology will become increasingly accessible to sports medicine professionals and athletes alike to minimize injury and keep our players on the field. This article serves to introduce technologies at our disposal to support injury prevention, whether it be prior to an injury or for the purpose of preventing reinjury upon return to sports.
Wearable Sensor Devices (WSDs)
Wearable sensor devices (WSDs) enable real-time monitoring of human performance across a variety of implementations and settings, allowing a collection of metrics not achievable otherwise. Benson et al[1] conducted a systematic review of 43 studies of WSDs and reported multiple outcome metrics were available to our athletes including step counts; foot and skin pressure; change of direction and inclination; displacement and velocity of body segments and joints; heart rate; sport-specific kinematics; range of motion; symmetry; alignment; head impact; and kinetic and spatiotemporal metrics. WSDs are being used in rehabilitation and may represent the missing link to quantitatively address return to play and performance.[2]
Considering these benefits, the NFL announced[3] its utilization of an injury prediction tool, the Digital Athlete, which takes video and data from training, practice, and in-game action to inform teams which players are at the highest risk of injury. Metrics including player load, changes of direction, and acute chronic workload ratio have been identified as key variables in injury prediction. WSD-derived metrics offer nuanced insight for individualized training loads according to sport-specific demands and player positions.[4] Coaches and training staff can use this data to design athlete-specific injury prevention, training, and recovery regimens.
Biomechanics Testing
In addition to incorporation of WSDs, an array of in-clinic and training room options, such as force plates and motion capture systems, exist to better evaluate biomechanics to inform injury prevention strategies. These systems identify asymmetries and deficits in motor control, as well as accurately observe movement patterns known to place an athlete at risk for injury. Hewett et al[1] has described a paradigm shift toward “preventative biomechanics,” where clinicians can identify the underlying mechanisms that lead to devastating injuries such as anterior cruciate ligament rupture in our healthy athletes. The authors suggest preventive biomechanics could be uniquely adapted to sport-specific needs to lower the incidence of traumatic and overuse injuries to both improve health outcomes and reduce medical expenditures.
VALD systems[1] – commonly found in training rooms and clinics - incorporate force plates, motion cameras, dynamometers, timing gate speed systems and isometric strength frames to inform injury risk stratification. Of interest, Parisien et al9 performed a study utilizing force-plate technology which demonstrated the ability to significantly reduce injury-related health care costs in National Collegiate Athletic Association Division I athletes via a comprehensive injury surveillance and prevention program. By assessing kinematic variables, high-risk athletes were flagged and individualized conditioning programs could be created. Users demonstrated a 23% reduction in clinic visits as compared with a 14% increase for nonusers (P = .049).
In summary, there is a wealth of data available through both wearable and clinic-based technologies. Analysis of workload, movement pattern, sport-specific kinematics, symmetry, and the impact of fatigue are just a few parameters which can influence an athlete’s reduction in injury risk. These advancements in data acquisition and interpretation not only enhance our understanding of injury prevention but also provide a path for athlete health and safety, performance, and career longevity.
References
- Benson LC, Räisänen AM, Volkova VG, Pasanen K, Emery CA. Workload a-WEAR-ness: Monitoring Workload in Team Sports With Wearable Technology. A Scoping Review. J Orthop Sports Phys Ther. 2020;50(10):549-563. doi:10.2519/jospt.2020.9753
- Black GM, Gabbett TJ, Cole MH, Naughton G. Monitoring Workload in Throwing-Dominant Sports: A Systematic Review. Sports Med. 2016;46(10):1503-1516. doi:10.1007/s40279-016-0529-6
- https://www.nfl.com/playerheal....
- Rebelo A, Martinho DV, Valente-Dos-Santos J, Coelho-E-Silva MJ, Teixeira DS. From data to action: a scoping review of wearable technologies and biomechanical assessments informing injury prevention strategies in sport. BMC Sports Sci Med Rehabil. 2023;15(1):169. doi:10.1186/s13102-023-00783-4
- Hewett TE, Bates NA. Preventive Biomechanics: A Paradigm Shift With a Translational Approach to Injury Prevention. Am J Sports Med. 2017;45(11):2654-2664. doi:10.1177/0363546516686080
- https://valdperformance.com/ne...
9. Parisien RL, Pontillo M, Farooqi AS, Trofa DP, Sennett BJ. Implementation of an Injury Prevention Program in NCAA Division I Athletics Reduces Injury-Related Health Care Costs. Orthop J Sports Med. 2021;9(9):23259671211029898. doi:10.1177/23259671211029898